At the University of Belgrade, a research team led by Professor Zoran Jovanovic, has developed an experimental medical data system for remote access via the Web. The team is partnering with the Euromed project workers to establish a standardised system for generating unique personal medical home page sites. At the ITIS'98 Conference, Professor Jovanovic and his colleague presented a first demo-version of the working prototype to show the audience that all basic concepts already are functioning. As a next step, clinical practice will be needed to optimise the system.
Before they could actually set up the medical data system, the researchers first had to attack a number of problems. A lot of databases and standards of course already exist and left the team with an important legacy that had to be implemented in the new system. Second, data should be provided on request and tele-conferencing capabilities installed. A third question relates to whether the physician needs to know where the data is. In fact, he doesn't, just as long as he knows what he needs. In fourth place, a transparent interface has to be created to hide the underlying complexity of specific elements. The issue where the standards should come constitutes the last difficulty to resolve. Here, the team followed an original approach by developing a set of Web templates.
The team went for a three-tier architecture, consisting of a Web server, a Web browser and the actual database management system (DBMS). The basic element is formed by the unique patient identification. From this point, remote access has to be established to the patient's medical data, which is distributed in databases throughout the world, each of them having its own Web interface. The name of the system is DIMEDAS, which stands for Distributed Medical Data System. Ideally, it has to enable doctors to reach via the Web all necessary patient information in a standardised way without having to worry on how to enter all those different hospital databases.
DIMEDAS consists of three elements: the administration part, the examination data entry, and the personal medical record. By means of Java plug-ins, the physician fills in the examination forms, an action which automatically leads to findings through the use of parameters. The results are presented in an Oracle database in the form of a patient report. Since various servers are being accessed through one client-PC, traffic speed sometimes might slow down. The system equally permits to add 3D-models which can be manipulated by means of different Java-tools for segmentation, generation of meshes with polygons, and simulation. Professor Jovanovic enthusiastically demonstrated the potential of the DIMEDAS multi-leveled structure to the ITIS participants.
DIMEDAS has the big advantage that it offers remote access to the original data-set located on the hospital server where the MRI has been performed. Consequently, there is no need for a gigantic capacity on the Internet to make the system work. Future goals consist in the further development of 3D ultrasound as a new but difficult technique, and in the complex pre-processing of old 2D images. The team will also have to focus on guaranteed security and privacy as well as on the definition of a cardiology standard. At this moment, DIMEDAS constitutes an interesting case tool for building systems which allow easy adding of new services with the help of Java plug-ins. The Web site of the University of Belgrade provides more information on this prototype system.